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EMAR Update An Acronym Soup Organic, No Preservatives…. Test your Data Acronym Knowledge • NHII: National Health Information Infrastructure • DHHS: Department of Health and Human Services • ONCHIT: Office of the Coordinator for Health Information Technology • ANSI: American National Standards Institute • HITSP: Healthcare Information Technology Standards Panel • EMAR: Emergency Medical Awareness and Response • OASIS: Organization for the Advancement of Structured Information Standards • HL7: Health Level 7 Main EMAR EMS Focus • Data Standards Harmonization – NEMSIS – DEEDS • Messaging Collaboration – HL7 – OASIS Context Diagram-Conceptual Information Flow GAP 911 Center Emergency Com System CAD Automobile Interface Telematics Alerts GAP Hospital Employee Portal 911 Center Emergency Com System CAD Current - NEMSIS XSD Future NEMSIS Transformed/Harmonized w/OASIS EDXL or HL7 (CAP and RM) The Hospital Enterprise GAP UserPCInterface Home and Remote Health Monitoring Devices GAP AD Auth./Author. HL7 Messages Clinical System POE HL7 Messages Billing AR I Engine HL7 Messages Core Services EMS Service Operational System (S) Multiple HL7/EDXL Messages Inbound and Out EMR Server GAP GAP DMZ Current - NEMSIS XSD Future NEMSIS/DEEDS Transformed/Harmonized w/OASIS EDXL or HL7 (RM) EDIS DEEDS HL7 Messages Firewall GAP Firewall HL7 Messages Lab Other Systems NDMS/Public Health, Payers etc... NEMSIS Trauma Clinical System Various Message Types GAP GAP GAP LAW Enforcement RHIO or HIE GAP ECON Registry Firewall Register System PHR/ EHR/PP HIE/RHIO Rules Engine Routing CAD-Computer Aided Dispatch AD-Active Directory AR-Accounts Receivable POE-P NDMS-National Disaster Medical System Wrapper Message Transport The Future EMAR Projects (June 2008 through December 2008) • Messaging Collaboration – HL7 – OASIS (September 2008 through December 2009) • Data Standards Harmonization – NEMSIS – DEEDS NEMSIS Version 3 Progress and Timeline Components • Data Elements – Existing 2.2.1 – Suggestions for Additions – Recommendations to Discontinue • XML Data Transmission – Not based on NEMSIS XML – Transition to HL7 • Version 2.5 (current) • Version 3.0 (the future…..) Possible Additional Content • NASEMSO State Data Managers – Data Element Variable Definitions • Data Exchange – – – – – Dispatch Centers Crash Notification Billing Medical Devices Others (patient tracking, triage, GIS) NEMSIS Data Dictionary v3 Wiki General Comments Thus Far • XML cleanup • NHTSA Injury and Assessment should be combined • Prior Aid not Needed • Impression/Complaint still needs work • Add Complete Dataset on Airway Management • Add Universal ID of some type • More International Locations • State Custom Data Elements • Expand to include Training Information • Tracking of Supplies • Include Performance Measures • Injury Data Poor • 12 Lead ECG Interpretation for STEMI • Decrease Null Values • Add more data elements to National Level Specific Data Needs • STEMI System of Care Data Elements • Stroke System of Care Data Elements • Cardiac Arrest Data Elements • Airway Data Elements • Mechanism of Injury and Cause of Injury Documentation • Documentation of Medications • New Procedures and/or Devices Anticipated Issues • Hospital vs. EMS Terminology – Impression vs. Diagnosis – Assessment vs. Exam • Limited (Pertinent) vs. Open Ended – ICD-9 – E-Codes • XML vs. HL7 Data Standards NEMSIS Version 3 Timeline